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Psychedelic therapy - what appearance, what course?

An article recently appeared in the NYT about the therapeutic use of psychedelic substances. In recent years, the topic of serotonergic hallucinogens - such as. psilocybin mushrooms - is increasingly being cited in the public space, and in turn experts see considerable medical potential in them. Which psychedelics can be used in modern psychedelic therapy? What is the basis of their operation? And above all - are they really effective? These and other questions will be answered in this article.

Psychedelic therapy - experts' attitudes toward effectiveness and potential risks

The U.S. Food and Drug Administration has issued an official regulation that in 2024, psilocybin and MDMA (commonly known as ecstasy) will be legalized, for the treatment of depression and post-traumatic stress disorder[5]. It is worth noting, however, that with the rise in popularity of the belief that psychedelics would become an important part of modern medicine, there is also no shortage of less enthusiastic attitudes. Indeed, specialists have noted a correlation between taking psychoactive substances and higher levels of emotional sensitivity[1].

Moreover, Dr. Charles Raison stressed that as of now, there are no reliable studies confirming the validity of the therapeutic methods used so far. As an example, it is worth mentioning the situation when, during a study to demonstrate the positive effects of psilocybin on patients suffering from drug-resistant depression, three of them reported attempts at self-harm and suicidal thoughts within a few weeks of the end of therapy.

Psychedelic therapy

Psychedelic therapy, despite its promising results in treating mental disorders, remains an object of controversy and concern. Many people are concerned about potential side effects, such as psychotic episodes or permanent changes in personality, although research on psychedelics suggests that these phenomena are rare and can be managed in controlled therapeutic conditionsPsilocybin and MDMA research is advancing in Europe, with some showing significant benefits in treating depression, anxiety and post-traumatic stress disorder (PTSD) . Despite this, psychoost are illegal in many countries, which is a barrier to access to the therapy and its wider clinical use . Therefore, there is a need for a dalliance, as well as the development of consistent therapeutic protocols, to safely and effectively harness the potential of psychedelics in the treatment of a variety of mental disorders .

Choosing the right therapist - what should I pay attention to?

It turned out that the final results that the therapy could potentially produce are influenced not only by the psychedelics themselves, but also by the therapist. Thus, before making a final decision on the choice of a particular clinic, such issues as the experience of a given specialist, the certificates he or she has obtained, education and completed courses and training should be taken into account. What you should pay attention to is, first of all, the fact that he has a certificate in psychedelic therapy. The therapist should also be thoroughly familiar with our condition and have detailed knowledge of our disease or condition.

As clinical director Amy Lehrner has repeatedly emphasized in her statements, the selection of a psychedelic therapist should be approached in the same way as the selection of any other expert. Only then can we be assured of a reliable, effective and completely safe and comfortable treatment process.

Preparation sessions - what role do they play in the therapeutic process?

A few days before starting the actual part of the therapy, the doctor is required to schedule a short preparatory session with his patient, usually lasting a few hours. At that time, the therapist may ask you about your medical history, as well as the symptoms you wish to get rid of and the expected results you think the therapy should produce. During treatment, you may encounter unpleasant discomforts, both physical and mental. The specialist's job is to teach you how to deal with them, for example, through appropriate breathing techniques or meditation. A rather controversial aspect of psychedelic therapy is touch, designed to calm a patient under the influence of psychoactive substances. Most of those treated unanimously declared that it should be limited to holding the patient's hand or arm. This is because otherwise, it can be perceived in a sexual context.

What practices do experts use during therapy sessions?

Before visiting a therapist's office and deciding to start therapy with hallucinogenic drugs, it's a good idea to be thoroughly familiar with the process, in order to avoid unpleasant surprises that could cause unnecessary stress or anxiety[2]. When it comes to drugs such as psilocybin or MDMA, in most cases, therapists do not engage in conversation with the patient, allowing him or her to fully focus and relax. Sometimes, the treatment process is also accompanied by calm music.

However, the question remains - what happens when traumatic visions from the past begin to haunt the patient during therapy, causing him to feel anxious, frightened and perhaps even panic? In that case, it is up to the specialist to calm the patient, for example, by using the breathing techniques with which he or she was introduced during the preparatory session. At the same time, it is worth noting here that the role of the therapist is not to distract his client from an uncomfortable issue, but to analyze it in depth. The patient should work through the once-suppressed sensations on his own, with the help of a specialist, in order to better understand his own position and emotional state. As Dr. Raison used to say, it is not the struggle with the experience that is the method to get rid of the mental blockage and anxiety, but its reexamination. For only then, can psychedelic therapy produce the desired results.

It should also be emphasized that the therapist's main role is not to indicate the path to be followed by the patient, but to follow it. Excessive interference namely, can make the therapy ineffective, as its course will not be dictated by the patient's private thoughts and feelings, but by the doctor's guidance.

It is also impossible not to cite here the opinion of Dr. McNamee, who was an active participant in clinical trials conducted to confirm the effectiveness of psychedelics in treating mental abnormalities. She debunked the common myth that a therapist participating in a session should encourage the patient to feel pain, in order to somehow confront his suffering.

Integration sessions, or patient follow-up after therapy

Once in therapy, the patient is not left alone[3]. Within days and weeks after the start of treatment, the patient attends so-called integration sessions, during which he and his therapist discuss the feelings, emotions and sensations occurring during therapy. This allows for a better understanding of oneself, helping to correctly read signals, images or memories from the past. In some cases, standard therapy is also supplemented with methods such as cognitive-behavioral therapy or acceptance and commitment therapy[4].

  • https://michalpasterski.pl/2020/02/zagrozenia-zwiazane-ze-spozyciem-psychodelikow/
  • https://www.tygodnikpowszechny.pl/terapia-psychodeliczna-164736
  • https://terapianowoczesna.pl/terapia-psychodeliczna/
  • https://www.nytimes.com/2023/06/03/well/mind/psychedelic-therapy.html
  • Carhart-Harris, R. L., & Goodwin, G. M. (2017). The Therapeutic Potential of Psychedelic Drugs: Past, Present, and Future. Neuropsychopharmacology, 42, 2105-2113.
  • Mithoefer, M. C., et al. (2019). MDMA-Assisted Therapy for PTSD: A Comparison of Intention to Treat and Per Protocol Analyses. Psychopharmacology, 236, 2713-2721.
  • Nutt, D., King, L. A., & Nichols, D. E. (2013). Effects of Schedule I Drug Laws on Neuroscience Research and Treatment Innovation. Nature Reviews Neuroscience, 14, 577-585.
  • Carhart-Harris, R. L., et al. (2018). Psychedelics and the Essential Importance of Context. Journal of Psychopharmacology, 32(7), 725-731.

Sources:

1. https://michalpasterski.pl/2020/02/zagrozenia-zwiazane-ze-spozyciem-psychodelikow/

2. https://www.tygodnikpowszechny.pl/terapia-psychodeliczna-164736

3. https://terapianowoczesna.pl/terapia-psychodeliczna/

4. https://terapianowoczesna.pl/terapia-psychodeliczna/

5. https://www.nytimes.com/2023/06/03/well/mind/psychedelic-therapy.html

  2. Carhart-Harris, R. L., & Goodwin, G. M. (2017). The Therapeutic Potential of Psychedelic Drugs: Past, Present, and Future. Neuropsychopharmacology, 42, 2105-2113.
  3. Mithoefer, M. C., et al. (2019). MDMA-Assisted Therapy for PTSD: A Comparison of Intention to Treat and Per Protocol Analyses. Psychopharmacology, 236, 2713-2721.
  4. Nutt, D., King, L. A., & Nichols, D. E. (2013). Effects of Schedule I Drug Laws on Neuroscience Research and Treatment Innovation. Nature Reviews Neuroscience, 14, 577-585.
  5. Carhart-Harris, R. L., et al. (2018). Psychedelics and the Essential Importance of Context. Journal of Psychopharmacology, 32(7), 725-731.